AccountId: 011433970860
ContactId: 09a32dba-4c8d-4e88-87a9-be1beb127016
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 533400 ms
Total Talk Time (AGENT): 227404 ms
Total Talk Time (CUSTOMER): 235723 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/09a32dba-4c8d-4e88-87a9-be1beb127016_20250121T17:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi, good morning. Uh, no, good afternoon. I'm sorry, it's [PII] here in [PII]. Uh, good, good afternoon. I'm like, oh, I'm so used to saying good morning. Uh, yeah, it's terminated. Uh, my, yes, my name is [PII]. I'm calling from Bathist Healthory. I have a question for you. So we have a member.
[AGENT][POSITIVE] Good afternoon.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Their primary insurance is terminated. Uh, can you guys, can you guys be primary or you only are secondary?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] We're only secondary.
[CUSTOMER][NEUTRAL] You're only what? I'm sorry?
[AGENT][NEUTRAL] We are only secondary.
[CUSTOMER][NEUTRAL] OK, so then we're gonna have to put him as self pay then.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] Oh, no.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] You know, people know that someone, this person, she presented a policy from like [PII] we're working on one from [PII], so since she had the UnitedHealthcare and I wanted to check the portal to see.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] But I'm like I don't know, I was confused with the portal. I was a little confused, so let me let me call, right, because we're technically she would be in inactive but we're if we're in January, right? You know, so it's like, let me, let me, let me just see and know she's terminating her policies for term [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, OK, Miss.
[CUSTOMER][NEUTRAL] And you always can't be and you go ahead.
[AGENT][NEUTRAL] Um, can you go ahead and give me, um, your callback number, the insured's name and their policy number or let me look on my end also?
[CUSTOMER][NEUTRAL] Are you, will you be able to see if there's like another insurance?
[AGENT][NEUTRAL] Well, I'll be able to see if our poli I'll be able to see if the policy is active or not, um.
[CUSTOMER][NEUTRAL] For the member?
[CUSTOMER][NEUTRAL] Well, so, but you said, OK, you said you you can't be primary though.
[AGENT][NEUTRAL] Because
[AGENT][NEUTRAL] Right, um, and I can also look and see if the poli see because if the primary insurance has lapsed.
[AGENT][NEUTRAL] If it's a Medlink policy, then
[AGENT][NEGATIVE] It would lapse with us too.
[AGENT][NEUTRAL] But if the primary is still active, I could look and see if she has an active policy, and if she does, I can look and see.
[CUSTOMER][NEUTRAL] Right, right, well.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Oh, OK, you wanna see?
[AGENT][NEUTRAL] Yeah, I wanna see just in case she may have a different one.
[CUSTOMER][NEUTRAL] OK, maybe they.
[CUSTOMER][NEUTRAL] OK, if not, there's no like the policy, then we'll just keep self pay.
[AGENT][NEUTRAL] OK, OK. And what is her policy number?
[CUSTOMER][NEUTRAL] OK, so let's see.
[CUSTOMER][NEUTRAL] Yes, 01663526 ML.
[AGENT][NEUTRAL] OK, let me pull it up and what's the insured's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] Her last name is [PII] She's born on [PII] sorry, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do see that she does have an active policy with us. Um, her effective date is [PII]. She's, um, paid current. Let me look and see if I can't find. I know there's, let me see if I can find.
[AGENT][NEUTRAL] A way to look up for her primary.
[AGENT][NEUTRAL] Who she may have with us now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] Cause I, I feel bad, but it's like, you know, people don't pay attention.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yeah, and sometimes they just forget to give you their new insurance card too, so I wanna make sure that's correct also, um.
[AGENT][NEUTRAL] Because if she, she has an active policy with us and she has to have an active primary insurance because this is a meddling policy. Wait a minute, let me make sure.
[AGENT][NEGATIVE] No, this is not a Meli policy.
[AGENT][NEUTRAL] Uh, let me look again.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look again. Let me pull it up again. I might have accidentally got out of it. I wanna make sure.
[AGENT][NEUTRAL] Dot Laruda, yes, it is a Medli policy so.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me look real quick and see if I can find a primary for her and see if it's the same as you have just in case.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] I'm gonna have to look on our group to see what a group.
[AGENT][NEUTRAL] It's gonna be just a second. I'm sorry. I just wanted to make sure and help you.
[CUSTOMER][NEUTRAL] No, no, no, of course.
[AGENT][NEUTRAL] If cause if she has a different one than what we're showing and you may have a different one, she may still have, you know what I'm saying? She may still have um coverage. OK, so I'm showing.
[AGENT][NEUTRAL] Oh, they are responsible for their own major medical so it does not show through my group dang it, I thought I'd be able to look and see what the group policy covered but it doesn't have the.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][POSITIVE] I apologize. I did want to try for you anyway.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, no, no, you did, but you know, unfortunately, right, people, I always say people have to learn.
[AGENT][NEUTRAL] Yeah, they do, they do.
[CUSTOMER][NEUTRAL] And, and, and you know, we call people all the time and ask, oh, I did that, you know, so they have to learn consequences, I.
[CUSTOMER][NEUTRAL] You know,
[AGENT][POSITIVE] Yeah, yes, ma'am, I do, I do.
[CUSTOMER][NEGATIVE] I hate, you know, I hate to be, I hate I'm not trying to I mean, but you know it's like.
[CUSTOMER][NEUTRAL] No, OK, so let me make a note on their account so that uh uh just stay on the phone because I wanna make sure I word it correctly or say that what people know, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][MIXED] I feel bad but uh it is what it is.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And tell me.
[CUSTOMER][NEUTRAL] Um, from United and removed.
[CUSTOMER][NEUTRAL] Insurance policy.
[CUSTOMER][NEUTRAL] Her other policy terminated [PII]. Can you imagine?
[AGENT][NEUTRAL] Oh my gosh, that's.
[CUSTOMER][NEUTRAL] And then and then I'm gonna say we were.
[AGENT][NEUTRAL] That's been a while.
[CUSTOMER][NEUTRAL] But it is what it is spoke with rep [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And removed, oh why, OK. [PII] and removed uh American Pub Life rep stated that it, it, it can be.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] right, it is only a gap plan and not primary.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, it'll never be primary and the thing about this policy or this plan is, it's based on what the primary pays too so if it's a non-covered service for primary then it's non covered with us also so we, we can't even pay until the the primary pays, so they always have to have a primary insurance.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Active.
[CUSTOMER][NEUTRAL] Right, so I said I spoke with you and that removed American Pub Life, and you said that it's only a gap plan and not primary marked as self-pay.
[AGENT][POSITIVE] Right, that's correct.
[CUSTOMER][NEGATIVE] I know I feel bad but.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, people don't, we, I see it all the time.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK, perfect. Well I'm sure we we'll talk soon. It's my 3rd time calling today American Public Life, so but we'll talk again.
[AGENT][NEUTRAL] Yes, I've talked to you before. I've, I think you and I have talked several times since I've been over in this.
[CUSTOMER][NEUTRAL] I think so too.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Well it was good talking to you again and we'll talk soon.
[AGENT][POSITIVE] OK, [PII]. You have a good rest of your day.
[CUSTOMER][POSITIVE] All right, you too. Take care. Bye-bye, [PII].
[AGENT][NEUTRAL] Bye bye